Per-oral, non invasive intestinal mucosa biopsy has proved useful in diagnosis, treatment and in understanding the pathophysiology of gastrointestinal diseases. The per-oral biopsy technique allows histopathologic and ultrastructural study of mucosal changes during life which are otherwise impossible because the small intestinal mucosa is rapidly destroyed after death. The full value of the mucosal biopsy has not been exploited in the study of childhood intestinal disease because few attempts have been made to adapt modern methods of bio-chemistry, physiology and cell biology to the study of intestinal mucosa biopsy samples. This proposal is for support to adapt certain biochemical methods to study of 3 to 15mgm biopsy samples of the diseased childhood intestinal mucosa. Specifically, intestinal mucosa fatty acid uptake and esterification in physiologic and non-physiologic conditions will be studied. Application of this technique to this and other areas of mucosal metabolism will ultimately allow the integration of pathophysiology, biochemistry and ultrastructural pathology in diseases of the human mucosa. The approach is particularly relevant and important in the study of childhood diseases because certain congenital defects of gastrointestinal absorption can be approached in no other way. The applicant has been investing 90% of his time and effort on this project during the past 18 months with private support through a fellowship from Chapter 18 of the United Order of the True Sisters of Ruth. Support through the Clinical Associate Physician Program of the Division of Research Resources will allow the applicant to substantially advance the research on a children's General Clinical Research Center at the Cincinnati Children's Research Foundation.